Disease Prevention in Women (cont.)

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Human immunodeficiency virus (HIV)

HIV is the virus that causes AIDS (Acquired immune deficiency syndrome). While modern anti-HIV medications have significantly improved long-term survival and quality of life of HIV infected individuals, there is still no cure or vaccine. HIV infection is still eventually lethal in everyone who is infected. Therefore, preventing the spread of HIV is the most important step in preventing illness and death due to HIV infection.

Screening tests

Screening blood test for antibodies to HIV is called an ELISA test. Confirmatory test for antibodies to HIV is called a Western blot.

HIV infected individuals can remain free of symptoms for many years; they will know if they are infected ONLY if a blood test for HIV is done. HIV testing can be performed by a physician or at a testing center.

Who should be tested

The following individuals should be routinely offered HIV testing:

pregnant women;

individuals with occupational exposure to HIV (health care workers and researchers working with HIV);

individuals with active tuberculosis, unexplained fevers, low white blood cell counts, or who have been diagnosed with a sexually transmitted infection.

Most infected individuals will develop a positive HIV blood test within three months of being exposed to HIV. If the HIV test at three months is negative and there are risk factors for infection, the test should be repeated in another three months.

Benefits of early detection

Theoretically, early treatment with anti-HIV medications may help the body's immune system fight the virus. So far, early treatment cannot cure or eradicate the virus. Therefore, early detection is most important to prevent the spread of the virus.

The virus is present in the blood, genital, and other body secretions of virtually all infected individuals, regardless of whether or not they have symptoms. The HIV virus is spread from one person to another when these secretions come in contact with the vagina, anal area, mouth, or eyes, or with a break in the skin, such as from a cut, bruise, sore, or puncture by a needle. Sexual transmission of HIV has been described from men to men, men to women, women to men, and women to women through vaginal, anal, and oral sex.

Prevention of spread of HIV

Abstinence from sex until both partners are certain that they are not infected (for example both partners test negative for HIV antibody after the last potential exposure). While most newly infected individuals test positive by two months after infection, up to 5% are still negative after six months with routine testing. If abstinence is not possible, use latex barriers such as a condoms and a dental dam (piece of latex that prevents vaginal secretions from coming in direct contact with the mouth.)

For pregnant women infected with HIV, proper prenatal counseling, treatment with anti-HIV drugs after the first trimester, proper handling of the delivery process, and short-term treatment of the newborn child can very substantially reduce HIV infection in the newborn.

Avoid sharing of needles, razor blades, and toothbrushes.

Health care workers who experience aneedle stick or exposure of the eyes, mouth, or injured skin from an infected person must take anti-HIV medication in order to reduce the risk of developing infection.